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Best Practices for Optimizing Core EHR Systems
Session #208, February 14, 2019
Chad Brisendine, CIO Brent Snyder, EVP, CIO
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Chad Brisendine, CIO, St Luke’s University Health Network
Brent Snyder, EVP, CIO, AdventHealth
Have no real or apparent conflicts of interest to report.
Conflict of Interest
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Learning Objectives
• Assess current performance of EHR with respect to specialty functions like
revenue cycle and patient access
• Recognize best practices for successful integration of specialty vendors
and systems using real world case studies
• Discuss success metrics from these implementations to build business
case for championing integrations within attendee’s own organization
• Identify available resources from EHR providers such as Epic and Cerner
to aid in successful integrations and deployments
• Develop realistic KPIs for system-specific integrations, including timeline,
performance metrics and ultimate return on investment
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• Evolving consumer expectations of healthcare
• CIO role in driving change
• AdventHealth success story
• St Luke’s University Health Network success story
• Takeaways for fellow CIO’s
Agenda
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Consumerism is the new reality
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Patient expectations set by retail
Convenience, Personalization, Self-service… whenever I want it
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Gap in financial experience
5-10%
10 years ago
25%+
today
3 in 4 patients
Don’t understand their
healthcare bill
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But financial experience
not keeping up
Patients share of hospital
revenue rising
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Sources:
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Healthcare Finance News: Revenue cycle vendors rush to innovate amid consumer changes in healthcare (12 Aug 2015)
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Beckers: 11 Key Statistics about Healthcare Payment Market (21 Jun 2016)
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Price transparency a leading demand
94%
Of patients expect price
transparency tools to be
available this year
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Sources:
1 Black Book survey of 650 consumers, July 2018
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Done right, a win-win
3x
More likely to
pay in full when
“very satisfied
with billing
experience”
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6x
More revenue
from patient
retained for
three years vs
new patient
who does not
return
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Sources:
1 Connance whitepaper, “The Impact of Consumerism on Healthcare”, Oct 2018
2 Advisory Board Company 2015 report, “Competing on Consumer Experience”
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• Consumerism is the new reality
• CIO role in driving change
• AdventHealth success story
• St Luke’s University Health Network success story
• Takeaways for fellow CIO’s
Agenda
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• CIO focus expanding to
include business return
• Seeking areas to build on
EHR foundation
• Patient-facing digital
solutions represent
opportunity
CIO’s become change agents
83%
Of technology leaders say
their role is more strategic
than 3 years ago
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#1
priority
Growth through digitized
products and services that
drive customer
engagement
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Source:
1 Korn Ferry 2018 survey
2 Gartner 2018 CIO Agenda Survey
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Patient experience a leading priority
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Unified experience challenged by growth
• Acquisition drives
proliferation of EHR
platforms
• Systems with ‘single’
EHR may have multiple
instances
Number of US hospital mergers
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Specialized tools to complement EHR
• EHR provides back end
data foundation
• 70% of systems seek
specialized patient
engagement solutions
Patient
engagement
% of executives seeking solutions
outside their EHR to deliver capabilities
70%
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• Consumerism is the new reality
• CIO role in driving change
• AdventHealth success story
• St Luke’s University Health Network success story
• Takeaways for fellow CIO’s
Agenda
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Overview of AdventHealth
47 campuses
9 states
9,000+ licensed
beds
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Patient financial experience goals
• Self service pre-
registration
• Pre-service payments
• Mobile experience
• Single, enterprise-wide bill
• Personalization
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Addressing top patient needs
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Unified post service experience
“It’s the best!! No checks, no
stamps. This is great. No need
of password and username!!”
AdventHealth patient
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Consolidated view across EHR’s
“I can see all my bills
which is nice
because there are so
many from child birth
it can get confusing.”
AdventHealth patient
Cerner Suncare Athena NextGen
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Patients require path to affordability
9 in 10patients
say healthcare is an
expense that requires
financing more than 12
months in duration
“The payment plan
won’t allow me to set up
a plan that is
reasonable for me.”
-Patient
• $120 average patient monthly
affordability
• Short term plans don’t address high
balances that make up 50%+ of bills
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New approach to affordability
Relevant,
predictive patient
data
Healthcare tuned
scoring algorithm
Patient capacity to
pay healthcare bill
Insuranc
e
Demographics
Past payment
behavior
Consolidated
medical bills
Total balance
+ other
attributes
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Personalized path to payment
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Personalization driving payment plan
success
% of payment plans
originated via self-
service
36%
70%increase in
self-service payment
90%+collection
rates from auto
payment plans with
payment instrument on
file
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Patient loyalty on the rise
23 =
Healthcare
billing office
average
AdventHealth patient NPS
(12k respondents per quarter)
“I love the consolidated billing!
It came promptly and I didn’t get
a run of bills for months”
AdventHealth patient
“I am very grateful that you
allowed me to make payments
on my multiple accounts over
the past year. This is very
helpful financially.”
AdventHealth patient
“Very easy! I was surprised
how easy it was.”
AdventHealth patient
+14%
NPS increase
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Pre-service vision
20% 80%
self check-in
in 8 years
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Sources:
1Drennen, Hannah. “Self Service Technology in Airports and the Customer Experience.” (2011). UNLV Theses/Dissertations/
Professional Papers/Capstones. Paper 1053. Accessed October 8. 2014.
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Self check-in for healthcare
Appointment
Reminder
Check-in
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Engaging patients where they are
Demographic
s
Consent forms
“I won’t have to fill
things out in the
waiting room with
nosey people and
kids running around”
AdventHealth patient
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Pre-service financial engagement
Early results
(10k patients)
1.7k patients engaged
$13Kcollected
$325average payment
44NPS
Estimate Payment
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• Consumerism is the new reality
• CIO role in driving change
• AdventHealth success story
• St Luke’s University Health Network success story
• Takeaways for fellow CIO’s
Agenda
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Overview of St Luke’s
Non-profit, regional, fully integrated, nationally recognized network
providing services at 10 hospitals and more than 250 outpatient
sites
13,000+employees 1,300+physicians
86,000annual admissions 270,000annual ED visits
The oldest nursing school in the nation and a school of medicine
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Patient financial experience goals
• Price transparency
• Personalized payment
options
• Consumer-centric experience
• Self-service adoption
• Increase patient satisfaction
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Consumer experience
• Single Web and App UI
• Epic SDK
• American Well
• Doctor.com
• Clockwise
• Simplee Pay & Price
Checker
• Chatbot
• Triage
90kusers
455ksessions
2.4Mviews
Current
Planned
Test
results
49%
Top features
Visit
history
42%
E-
checkin
5%
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Re-thinking price transparency
• High deductible plans
drives need for consumers
to shop for services
• Patients want to pay for the
bundle, not just one service
• Earlier is always better for
patient payments
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Transparency ahead of scheduled visit
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Payment options personalized
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Success with Price Checker
3.5kpatients in 2018
“While we believe that the CMS requirement is a move in the right
direction, it does not provide patients with an easy answer to what
health services actually cost. While our price checker tool continues
to evolve, our hope is that more hospitals will follow our lead and create
true transparency pricing to make it easier for patients to make health
care decisions.”
Francine Botek, SVP Finance
St Luke’s University Health Network
Interview with “The Morning Call”
$9Mrevenue in 2018
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Experience built for self-service
Clear statement, path to self-service
Pay my bill call to action – no account required
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Personalized path to payment
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Patients adopting self-service
84%
71%increase in self-
service payment rate
% of payments via
self-service
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High mobile engagement
40%
mobil
e
56%
mobil
e
40% online payments from mobile - higher than
ecommerce
(24% of retail ecommerce occurs via mobile device
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)
Source:
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ComScore State of the US Online Retail Economy, 1Q18
44%
deskto
p
60%
deskto
p
Bill page views
Payments
completed
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Staff call volumes decreasing
50% customer service
payments converted to IVR
120 fewer calls per day
$0.3M cost savings
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Payment plan adoption increasing
Payment plan
origination
Self-service
payment plan
origination
19%
increase plan
volume
18%
increase self-
service
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Patients loving the change
“I’m very happy with St
Luke’s. I love the ease in
setting up a payment plan
and viewing my bill.”
St Luke’s patient
“Easy, convenient, patient-
centered. Thank you for
offering installment plans,
they help a lot!”
St Luke’s patient
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Healthcare billing office
average
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Source: St Luke’s NPS based on 6,599 patient responses. Comcast, Nordstrom, Mercedes Benz NPS from
npsbenchmarks.com. Healthcare average from Connance report, 2018
Net Promoter Score
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• Consumerism is the new reality
• CIO role in driving change
• AdventHealth success story
• St Luke’s University Health Network success story
• Takeaways for fellow CIO’s
Agenda
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Takeaways
• Embrace patient demand for Consumerism
• Assess gaps in patient and staff experience in meeting needs
• Aim to delight patients and create a multi-year roadmap to support
• Partner with best in class patient-facing experiences
• Track financial and patient experience success metrics
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Questions
Chad Brisendine, CIO
St Luke’s University
Health Network
Brent Snyder, EVP, CIO
AdventHealth
